Appendix I Nurse (stage 2) overview and documents

I1 Overview of information collected during the nurse stage

Table I.1 summarises the information collected during the nurse stage. Where information was only collected in one fieldwork year (rather than in both Year 5 and 6) or was limited to particular age groups, this is specified.

| Measurement or procedure | Participant | |-------------------------------------------|--------------------------------------------------| | Details of prescribed medications | All ages | | Blood pressure | Aged 4 years and over | | Infant length measurements | Aged 18-23 months | | Waist and hip circumferences | Aged 11 years and over | | Demispan(^i) | Aged 65 years and over and those aged 16-64 years where height could not be measured | | Mid Upper Arm Circumference (MUAC) | Aged 2-15 years; Year 5 only. | | 24-hour urine collection | Aged 4 years and over fully out of nappies; Year 5 only | | Non-fasting blood sampling | Aged 1.5-3 years and diabetics not willing to Fast | | Fasting blood sampling | Aged 4 years and over |

The CAPI nurse interview and documents used during the nurse stage are shown in the remainder of this Appendix.

(^i) Demispan was measured in participants for whom, for postural reasons, a measure of height would give a poor measure of stature (e.g. in some elderly people, or for people with certain disabilities). Demispan is strongly related to a person’s height and is the distance between the sternal notch and the finger roots with the arm out-stretched laterally. National Diet and Nutrition Survey (NDNS)

N10041 Year 9

Program Documentation

Nurse Schedule

This ‘paper version of the program’ has been created to indicate the wording and content of the nurse questionnaire.

• Instructions for the nurse are given in capital letters, and questions the nurse is to ask the respondent are given as normal text.

• Items which appear in the actual program but which have been excluded here for clarity include: Repetition of respondent’s name on each question; Checks on the accuracy of answer codes in relation to each other; Prompts for back-coding during the edit process.

Contents:

HOUSEHOLD GRID ........................................................................................................2 NURSE SCHEDULE ........................................................................................................4 INFANT LENGTH ...........................................................................................................10 FOR RESPONDENTS AGED 18 MONTHS TO 2 YEARS ..............................................10 PRESCRIBED MEDICATIONS .....................................................................................12 BLOOD PRESSURE ......................................................................................................15 FOR RESPONDENTS AGED 5 AND OVER WHO ARE NOT PREGNANT ...............15 DEMI-SPAN ..................................................................................................................20 FOR ALL RESPONDENTS AGED 65 AND OVER OR THOSE WITH AN UNRELIABLE HEIGHT MEASUREMENT .................................................................20 WAIST AND HIP ..........................................................................................................22 FOR RESPONDENTS AGED 11 AND OVER WHO ARE NOT PREGNANT ...........22 BMI TO GP CONSENT ..................................................................................................25 BLOOD SAMPLE ...........................................................................................................38 FOR ALL RESPONDENTS WHO ARE NOT PREGNANT ........................................38 DRUGS ..........................................................................................................................53 **HOUSEHOLD GRID**

**Person** Person number : 1..2

**HHGridNo** Household grid number : 1..10

**Name** Name : STRING [20]

**Sex** 1 Male 2 Female

**AgeOf** Age : 0..120

**AgeOfM** Age in months : 00..1440

**OC** Agreed nurse? 1 Agreed 2 Refused 3 Unsure

Press <Ctrl Enter> to select a nurse schedule for the person you want to interview, or to quit this form. NURSE SCHEDULE

IF (participant agreed nurse visit) THEN Info NURSE: You are in the Nurse Schedule for... Person (Person number) Name (Participant name) Age (Participant age at date of 1st interviewer visit) DOB (Participant date of birth) Sex (Participant sex) Height (Participant Height cm) Weight (Participant Weight kg) BMI (Participant BMI)

1 Yes “Yes, I will do the interview now” 2 No “No, I will not be able to do this interview”

IF (participant was unsure about nurse visit) THEN Info NURSE: You are in the Nurse Schedule for... Person (Person number) Name (Participant name) Age (Participant age at date of 1st interviewer visit) DOB (Participant date of birth) Sex (Participant sex) Height (Participant Height cm) Weight (Participant Weight kg) BMI (Participant BMI)

NURSE: THIS PARTICIPANT WAS UNSURE ABOUT THE NURSE VISIT WHEN ASKED BY THE INTERVIEWER.

1 Yes “Yes, I will do the interview now” 2 No “No, I will not be able to do this interview”

IF (Info = Yes) THEN StrtNur Start time of the interview : TIMETYPE

MachDate Automatically recorded date of interview : DATETYPE

NEndDate Date at end of interview : DATETYPE

NurDate NURSE: Enter the date of this interview : DATETYPE NDoBD Can I just check your date of birth? NURSE: Enter day, month and year of (participant’s name)’s date of birth separately. Enter the day here. : 1…31

NDoBM NURSE: Enter the code for the month of (participant’s name)’s date of birth. 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December

NDoBY NURSE: Enter the year of (participant’s name)’s date of birth. : 1890..2015

NDoB Date of birth (derived) : DATETYPE

IF (NDoB \<> RDoB) THEN DoBDisc NURSE: Please explain the difference between date of birth the Interviewer recorded (Date of birth of participant) and date of birth you have just recorded (Date of birth derived). :OPEN

HHAge (Derived) Age of participant based on Nurse entered date of birth and date at time of household interview. : 0..120

ConfAge (Derived) : 0..120

IF (Age ≤ 15) THEN CParInt NURSE: A child can only be interviewed with the permission of, and in the presence of, their parent or a person who has (permanent) legal parental responsibility (specify names), “parent”. No measurements should be carried out without the agreement of both the parent and the child. N.B Written child assent, where appropriate, should also be sought from children who are able to give it. Press \<1> and <Enter> to continue. 1 Continue InfSH Have you read and understood the (parent/guardian) nurse information sheet and have I answered any questions you may have? 1 Yes "Read and understood info sheet", 2 No "Not read or understood info sheet"

If (InfoSh=Yes) Code01 NURSE: ASK PARTICIPANT (Parent/Guardian) TO INITIAL STATEMENT 1 BOX IN THE CONSENTS' SECTION IN THE OFFICE BOOKLET AND THE PERSONAL CONSENT BOOKLET. MAKE SURE YOU USE THE CORRECT AGE CONSENT FORM. MAKE SURE PARTICIPANT'S NAME IS FILLED IN IN BOTH COPIES. ASK PARTICIPANT TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES. CIRCLE CONSENT CODE 01 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue, 1 Continue

If (InfoSh=No) NURSE: Please double-check participant's willingness to take part in the visit. Code02 NURSE: CIRCLE CONSENT CODE 02 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (InfoSh=Yes) THEN WDraw NURSE: Are you aware your / your child's participation is voluntary and that you/they can withdraw at any time?" 1 Yes "I understand voluntary and can withdraw", 2 No "I don't understand voluntary and can withdraw"

If (WDraw=Yes) Code03 NURSE: ASK PARTICIPANT (Parent/Guardian) TO INITIAL STATEMENT 2 BOX IN THE CONSENTS' SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET. MAKE SURE YOU USE THE CORRECT AGE CONSENT FORM. MAKE SURE PARTICIPANT'S NAME IS FILLED IN IN BOTH COPIES. ASK PARTICIPANT'S TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES. CIRCLE CONSENT CODE 03 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (WDraw=No) NURSE: Please double-check participant's willingness to take part in the visit. Code04 CIRCLE CONSENT CODE 04 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (WDraw=Yes) AND (HHAge IN (5..15)) THEN ChAss NURSE: GO THROUGH THE CHILD ASSENT FORM. IF POSSIBLE AND CHILD AGREES, ASK THE CHILD TO COMPLETE (CIRCLING EACH STATEMENT), SIGN AND DATE THE FORM.

YOU AS THE NURSE MUST ALSO SIGN THE FORM.

HAS CHILD ASSENT BEEN GIVEN? 1 Yes 2 No

If (ChAss=No) ChAssN NURSE: WHY HAS CHILD ASSENT NOT BEEN GIVEN? BECAUSE THE PARENT / LEGAL GUARDIAN HAS CONSENTED TO THEIR CHILD'S PARTICIPATION YOU CAN STILL CONTINUE WITH THIS VISIT.

1 Yng "Child too young to read and/or write", 2 Und "Child too young to understand the study or their participation", 3 Other "Other answer"

IF (ChAssN=Other) ChAssNO NURSE: Please state other reason why child assent has not been given. :OPEN

IF (Sex=Female) AND (Age = 16-49) THEN PregNTJ Can I check, are you pregnant or breastfeeding at the moment? 1 Yes 2 No

IF (Sex = Female) AND (Age = 10 – 15) THEN UPreg NURSE: Has the respondent (or her parent/ guardian) told you that she is pregnant or breastfeeding? Do Not ask for this information – only code whether or not it has been volunteered.

Pregnant – Yes told me she is pregnant/ breastfeeding NotTold – No not told me she is pregnant/ breastfeeding IF PregNTJ = Yes OR UPreg = Pregnant THEN PregMes NURSE: Participant is pregnant. No measurement to be done. Press \<1> and <Enter> to continue. NCpregJ = Pregnant (Computed) ELSE NCpregJ = NotPreg (Computed) NoCodeB NURSE: NO MEASUREMENT TO BE TAKEN. CIRCLE CONSENT CODES 02, 04, 06, 08, 10, 12, 14 AND 16 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue.

IF (NCpregJ = NotPreg) THEN HlthCh (Can I just check,) have there been any changes to your/your child’s general health since you/he/she were/was visited by the interviewer? 1 Yes 2 No

IF (HlthCh = Yes) THEN HlthChWh INTERVIEWER: PLEASE RECORD DETAILS OF THE PARTICIPANT’S CHANGE IN GENERAL HEALTH. : OPEN

MedCNJD Are you /is (child’s name) taking or using any medicines, pills, syrups, ointments, puffers or injections prescribed for you/ (him/her) by a doctor or a nurse? NURSE: If statins have been prescribed by a doctor please code them here. If they have been bought without a prescription code at Statins question. NURSE: INCLUDE DIETARY SUPPLEMENTS AS LONG AS PRESCRIBED. MEDICINES SHOULD BE BEING TAKEN NOW, OR BE CURRENT PRESCRIPTIONS FOR USE 'AS REQUIRED.' 1 Yes 2 No

IF (NCpregJ=NotPreg) AND (age >= 16) THEN Statins Are you taking statins (drugs to lower cholesterol) bought over the counter from a pharmacist, without the prescription of a doctor? 1 Yes 2 No

IF (Statins = Yes) THEN StatinA Have you taken/used any statins in the last 7 days? 1 Yes 2 No

IF (MedCNJD = Yes) THEN MedIntro Could I take down the names of the medicines, including pills, syrups, ointments, puffers or injections, prescribed for you/(child’s name) by a doctor? Press \<1> and <Enter> to continue. 1 Continue PRESCRIBED MEDICATIONS

{Following questions asked as a loop:}

IF (MedCNJD = Yes) THEN MedBI NURSE: Enter name of drug no. (number) Ask if you can see the containers for all prescribed medicines currently being taken. If Aspirin, record dosage as well as name. : STRING[50]

MedBIA Have/Has you/(child's name) taken/used (text from MedBI) in the last 7 days? 1 Yes 2 No

MedBIC NURSE CHECK: Any more drugs to enter? 1 Yes 2 No REFUSALS

NoBP NURSE: No blood pressure reading to be done. Press \<1> and <Enter> to continue. 1 Continue

IF (Age >=8) AND ((BSWill = No) OR (ClotB = Yes or NONRESPONSE) OR (Fit = Yes OR NONRESPONSE) OR (Age = 2-3) OR (GuardCon = No) OR ((AmetopUse= Yes) AND Allergy = Yes) AND (NoAmetop = No)) OR (CBSConst = No)) THEN NoCodes NURSE: NO BLOOD TO BE TAKEN. CIRCLE CONSENT CODES 10, 12, 14, and 16 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF NCPregJ = Pregnant THEN NoCodeB NURSE: NO MEASUREMENTS TO BE TAKEN. CIRCLE CONSENT CODES 02, 04, 06, 08, 10, 12, 14 and 16 AT QUESTION 8 ON THE FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF NCPregJ = NotPreg THEN AllCheck NURSE: Check before leaving the respondent: #That (participant’s name) has their Personal Consent Booklet. #That full GP details are entered on front of the Office Consent Booklet. #The name by which GP knows participant is entered on the front of the Office Consent Booklet. #That all participant details are completed on front of the Office Consent Booklet. #That all necessary initials and signatures have been collected in both consent booklets. #That appropriate codes have been circled at Question 8 on the front of the office consent booklet. (For those who have agreed a return visit to give a blood samples, there will be further consents to collect at the return visit). Press \<1> and <Enter> to continue. 1 Continue EndReach NURSE: End of questionnaire reached.

IF (DoBlood [NSeqNo]= NotDone) THEN Don’t forget to make an appointment to come back and take the blood sample. Press \<1> and <Enter> to continue. 1 Continue

NurOut NURSE: Why were you not able to complete the nurse schedule for person (Person Number: participant Name)? 1 NotToBe (800) "Refuses nurse visit - not to be interviewed", 2 Complete (810) "Nurse schedule completed" 3 NoContact (820) "No contact made", 4 PerRef (830) "Refusal by person", 5 ProxRef (840) "Proxy refusal", 6 Broken (850) "Broken appointment", 7 IllHome (860) "Ill (at home)", 8 IllHosp (870) "Ill (in hospital)", 9 Away (880) "Away (other reason)", 10 Other (890) "Other reason for schedule not being completed"

IF (Info = Yes) OR (InfSh = No) OR (WDraw = No) THEN Thank NURSE: Thank participant for his/her co-operation. Then press \<1> and <Enter> to finish. 1 Continue

StrtTime Start time for : (Module name) Just press <Enter> : ARRAY [0..10] OF TIMETYPE

Elapsed Timing for : (Module name) Just press <Enter>. : ARRAY [0..10] OF TTime, INFANT LENGTH FOR participants AGED 18 MONTHS TO 2 YEARS

IF (Age< 2) THEN LgthMod NURSE: Now follows the Infant Length module Please press \<1> and <Enter> to continue. 1 Continue

IF (Age< 2) THEN LgthInt (As I mentioned earlier,) I would like to measure (child’s name)’s length. IF ASKED: This gives us information about your child's growth. 1 Agree “Length measurement agreed” 2 Refuse “Length measurement refused” 3 Unable “Unable to measure length for other reason”

IF (LgthInt = Agree) THEN Length NURSE: Measure infant’s length and record in centimetres. If measurement not obtained, enter ‘999.9’. Range: 40.0..999.9

IF (Length = RESPONSE) and (Length \<> 999.9) THEN LgthRel NURSE: Is this measurement reliable? 1 Yes 2 No

IF (Length=999.9 or EMPTY) THEN YNoLgth NURSE: Give reason for not obtaining a length measurement 1 Refuse “Measurement refused” 2 TryNot “Attempted, not obtained” 3 NoTry “Measurement not attempted”

IF (YNoLgth = Refuse.. NoTry) OR (LgthInt = Refuse, Unable) THEN NoAttL NURSE: Give reason for (refusal/not obtaining measurement/not attempting the measurement). 1 Asleep “Child asleep” 2 Fright “Child too frightened or upset” 3 Shy “Child too shy” 4 Lie “Child would not lie still” 95 Other “Other reason(s)” IF (NoAttL = Other) THEN OthNLth NURSE: Enter details of other reason(s) for not obtaining/attempting the length measurement. : STRING [100]

IF (Length = RESPONSE) and (Length \<> 999.9) THEN MbkLgth NURSE: Write the results of the length measurement on participant’s Measurement Record Card. Press \<1> and <Enter> to continue 1 Continue BLOOD PRESSURE FOR PARTICIPANTS AGED 4 AND OVER WHO ARE NOT PREGNANT

ASK ALL AGED 4+ EXCEPT PREGNANT WOMEN

BPMod NURSE: Now follows the Blood Pressure module. Press \<1> and <Enter> to continue. 1 Continue

IF (Age >=16) THEN BPIntro (As I mentioned earlier) We would like to measure your/(child’s name)’s blood pressure. The analysis of blood pressure readings will tell us a lot about the health of the population. Press \<1> and <Enter> to continue

IF (Age 4 -15) THEN BPBlurb NURSE: Read out to parent (parent): (As I mentioned earlier) we would like to measure your/(child’s name)’s blood pressure. If you wish, I will write the results on your/(his/her) Measurement Record Card. I will not, however, be able to tell you what the results mean. This has to be calculated using your/(his/her) age, sex and height. Also blood pressure can vary from day to day and throughout the day, so one high reading would not necessarily mean that you/(he/she) have/(has) high blood pressure. However, if you would like us to, we will send your/(his/her) results to your/(his/her) GP who is better placed to interpret them. In the unlikely event that (respondent’s name) should be found to have a high blood pressure for your/(his/her) age and height, we shall advise your/(his/her) GP (with your permission) that your/(his/her) blood pressure should be measured again. Press \<1> and <Enter> to continue. 1 Continue

BPConst NURSE: Does the participant agree to blood pressure measurement? 1 Agree “Yes, agrees” 2 Refuse “No, refuses” 3 Unable “Unable to measure BP for reason other than refusal”

IF (BPConst = Agree) AND (Age =13 - 65) THEN ConSubX May I just check, have you eaten, smoked, drunk alcohol or done any exercise in the past 30 minutes? CODE ALL THAT APPLY. 1 Eat “Eaten” 2 Smoke “Smoked” 3 Drink “Drunk alcohol” 4 Exercise “Done vigorous exercise” 5 None “(None of these)” IF (BPConst = Agree) AND (Age > 65) THEN ConSubX May I just check, have you eaten, smoked, drunk alcohol or done any exercise in the past 30 minutes? CODE ALL THAT APPLY. 1 Eat “Eaten” 2 Smoke “Smoked” 3 Drink “Drunk alcohol” 4 Exercise “Done exercise” 5 None “(None of these)”

IF (BPConst = Agree) AND (Age 4 - 12) THEN ConSubX2 May I just check, has (participant’s name) eaten, or done any vigorous exercise, in the past 30 minutes? CODE ALL THAT APPLY. 1 Eat “Eaten” 2 Exercise “Done vigorous exercise” 3 None “Neither”

DINNo NURSE: Please record the Omron serial number. E.g. if it says ‘LOM 111’, enter ‘111’ : 001..999

CufSize NURSE: Select cuff and attach to the participant’s right arm. Ask the participant to sit still for five minutes. READ OUT: ‘I am going to leave you to sit quietly now for 5 minutes. During that time you must not read and your legs are to remain uncrossed. After the 5 minutes, I will carry out 3 recordings with a minute between them. While I am doing these recordings I will not speak to you, and you must not speak to me. Once I have completed the recordings I will tell you what they are.’ Record cuff size chosen. Cuff size 1 Small “Small (15-22 cm)” 2 Medium “Medium (22-32 cm)” 3 Large “Large (32-42 cm)”

(Sys to Pulse repeated for up to three blood pressure readings)

Sys NURSE: Enter the (first/second/third) systolic reading (mmHg). If reading not obtained, enter 999. : 001..999

Dias NURSE: Enter the (first/second/third) diastolic reading (mmHg). If reading not obtained, enter 999. : 001..999

Pulse NURSE: Enter the (first/second/third) pulse reading (bpm). If reading not obtained, enter 999. NDNS YEAR 9 CAI_NURSE

: 001..999

Full All readings OK 1 Yes 2 No

IF (AT LEAST ONE '999' RESPONSE IN ALL THREE SETS OF READINGS) THEN

YNoBP NURSE: Enter reason for not recording any full BP readings. 1 Tried "Blood pressure measurement attempted but not obtained" 2 NoTry "Blood pressure measurement not attempted" 3 Refused "Blood pressure measurement refused"

RespBPS (derived) 1 Three "Three" 2 Two "Two" 3 One "One" 4 Tried "Tried" 5 NoTry "NoTry" 6 Refused "Refused"

IF (RespBPS = Two..Refused) OR (BPConst = Refuse or Unable) THEN

NAttBPD2 NURSE: Record why (only two readings obtained/only one reading obtained/reading not obtained/reading not attempted/reading refused/unable to take reading). CODE ALL THAT APPLY. 0 PC "Problems with PC/ laptop" 1 Upset "participant upset/anxious/nervous" 2 Error1 "Error reading" 3 Shy "Too shy (children)" 4 Fidget "Child would not sit still long enough" 5 Other "Other reason(s) (specify at next question)" 6 Cuff "Problems with Cuff fitting/painful" 7 Omron "Problems with Omron readings (zeros, no readings)"

IF (NAttBPD2 = Other) THEN

OthNBP NURSE: Enter full details of other reason(s) for not obtaining/attempting three BP readings. : STRING [140]

IF (RespBPS = One, Two or Three) THEN

DifBPC NURSE: Record any problems taking readings. CODE ALL THAT APPLY. 1 NoProb "No problems taking blood pressure" 2 LeftOnly "Reading taken on left arm because right arm not suitable" 3 Upset "participant was upset/anxious/nervous" 4 Other "Other problems (specify at next question)" 5 Cuff "Problems with cuff fitting/painful" 6 Omron "Problems with Omron readings (zeros, no readings)" IF (DifBPC = Other) THEN OthDifBP NURSE: Record full details of other problem(s) taking readings. : STRING [140]

GPRegBP Are/is you/(child's name) registered with a GP? 1 Yes 2 No

IF (GPRegBP = Yes) THEN GPSend May we send your/(child's name)'s blood pressure readings to your/(his/her) GP? 1 Yes 2 No

IF (GPSend = No) THEN GPRefC NURSE: Specify reason(s) for refusal to allow BP readings to be sent to GP. CODE ALL THAT APPLY. 1 NeverSee "Hardly/Never sees GP" 2 GPKnows "GP knows participant's BP level" 3 Bother "Does not want to bother GP" 4 Other "Other (specify at next question)"

IF (GPRefC = Other) THEN OthRefC NURSE: Give full details of reason(s) for refusal. : STRING [140]

IF (GPReg \<> Yes) OR (GPSend = No) THEN Code06 NURSE: CIRCLE CONSENT CODE 06 (NO CONSENT FOR BLOOD PRESSURE TO GP) AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (GPSend = Yes) THEN Code05 NURSE: FOR ADULTS OR CHILDREN AGED 4 TO 15 ASK PARTICIPANT TO INITIAL CONSENT STATEMENT 3 'BLOOD PRESSURE RESULTS TO GP' IN THE OFFICE AND PERSONAL CONSENT BOOKLET. PARTICIPANT TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES (IF NOT ALREADY DONE). CHECK THAT GP NAME, ADDRESS AND PHONE NUMBER ARE RECORDED ON FRONT OF OFFICE CONSENT BOOKLET. CHECK NAME BY WHICH GP KNOWS PARTICIPANT, AND ENTER ON FRONT OF OFFICE CONSENT BOOKLET. CIRCLE CONSENT CODE 05 AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue BPOffer NURSE: Offer blood pressure results to participant/(participant’s parent). (Displays readings) Systolic Diastolic Pulse i)\
ii)\
iii)\
Enter these on (participant’s name)’s Measurement Record Card Press \<1> and <Enter> to continue 1 Continue

IF (age >= 16) AND (conrais = 1) THEN TICK THE CONSIDERABLY RAISED BOX AND READ OUT TO participant: Your blood pressure is high today. Blood pressure can vary from day to day and throughout the day so that one high reading does not necessarily mean that you suffer from high blood pressure. You are strongly advised to visit your GP within 5 days to have a further blood pressure reading to see whether this is a once-off finding or not. NURSE: If RESPONDENT IS ELDERLY, ADVISE HIM/ HER TO CONTACT GP WITHIN NEXT 7-10 DAYS.

IF (age >= 16) AND (modrais = 1) THEN TICK THE MODERATELY RAISED BOX AND READ OUT TO participant Your blood pressure is a bit high today. Blood pressure can vary from day to day and throughout the day so that one high reading does not necessarily mean that you suffer from high blood pressure. You are advised to visit your GP within 2-3 weeks to have a further blood pressure reading to see whether this is a once-off finding or not.

IF (age >= 16) AND (milrais = 1) THEN TICK THE MILDLY RAISED BOX AND READ OUT TO participant Your blood pressure is a bit high today. Blood pressure can vary from day to day and throughout the day so that one high reading does not necessarily mean that you suffer from high blood pressure. You are advised to visit your GP within 3 months to have a further blood pressure reading to see whether this is a once-off finding or not.

IF (age >= 16) AND (normbp = 1) THEN TICK THE NORMAL BOX AND READ OUT TO participant Your blood pressure is normal. DEMI-SPAN

FOR ALL participant AGED 65 AND OVER OR THOSE WITH AN UNRELIABLE HEIGHT MEASUREMENT

SpanIntro NURSE: Now follows the Measurement of Demi-span. Press \<1> and <Enter> to continue. 1 Continue

SpanInt I would now like to measure the length of your arm. Like height, it is an indicator of size. NURSE CODE: 1 Agree "participant agrees to have demi-span measured" 2 Refuse "participant refuses to have demi-span measured" 3 Unable "Unable to measure demi-span for reason other than refusal"

Repeat for up to three demi-span measurements. Third measurement taken only if first two measurements differ by more than 3cm.

IF (SpanInt = Agree) THEN Span NURSE: Enter the (first/second/third) demi-span measurement in centimetres. If measurement not obtained, enter '999.9'. : Range: 5.0..1000.0

IF (Span \<> 999.9) THEN SpanRel NURSE: Is the (first/second/third) measurement reliable? 1 Yes 2 No

IF (Span = 999.9 (both attempts)) THEN YNoSpan NURSE: Give reason for not obtaining at least one demi-span measurement. 1 Refuse "Measurement refused" 2 TryNot "Attempted but not obtained" 3 NoTry "Measurement not attempted"

IF (YNoSpan = Refuse OR TryNot OR NoTry) THEN NotAttM NURSE: Give reason for (refusal/not obtaining measurement/measurement not being attempted). 1 Bent "Cannot straighten arms" 2 Bed "participant confined to bed" 3 Stoop "participant too stooped" 4 NotUnd "participant did not understand the procedure" 5 Other "Other" IF (NotAttM = Other) THEN OthAttM NURSE: Give full details of other reason for (refusal/not obtaining measurement/measurement not being attempted). : STRING [140]

IF (Span \<> 999.9) THEN SpnM NURSE CHECK: Demi-span was measured with the participant: CODE ALL THAT APPLY. 1 Wall "Standing against the wall or another flat surface" 2 NoWall "Not standing against the wall or another surface" 3 Sitting "Sitting" 4 Lying "Lying down" 5 LeftArm "Demi-span measured on left arm due to unsuitable right arm"

IF (Span \<> 999.9) THEN DSCard NURSE: Write results of demi-span measurement on participant’s Measurement Record Card. Demi-span (Result 1) (Result 2) Press \<1> and <Enter> to continue. 1 Continue WAIST AND HIP FOR participants AGED 11 AND OVER WHO ARE NOT PREGNANT

WHMod NURSE: Now follows the Waist and Hip Circumference Measurement. Press \<1> and <Enter> to continue. 1 Continue

WHIntro I would now like to measure your waist and hips. The waist relative to hip measurement is very useful for assessing the distribution of weight over the body. NURSE CODE: 1 Agree "participant agrees to have waist/hip ratio measured" 2 Refuse "participant refuses to have waist/hip ratio measured" 3 Unable "Unable to measure waist/hip ratio for reason other than refusal"

Repeat for up to three waist-hip measurements. Third measurement taken only if first two measurements differ by more than 3cm.

IF (WHIntro = Agree) THEN Waist NURSE: Measure the waist and hip circumferences to the nearest mm. Enter the (first/second/third) waist measurement in centimetres. (Remember to include the decimal point.) If measurement not obtained, enter '999.9'. Range: 40.0..1000.0

IF (WHIntro = Agree) THEN Hip NURSE: Measure the waist and hip circumferences to the nearest mm. Enter the (first/second/third) measurement of hip circumference in centimetres. (Remember to include the decimal point.) If measurement not obtained, enter '999.9'. Range: 50.0..1000.0

IF (WHIntro = Agree) THEN RespWH Imputed 1 Both "Both obtained" 2 One "One obtained" 3 Refused "Refused" 4 NoTry "NoTry"

IF (Waist = 999.9 (either attempt)) OR (Hip = 999.9 (either attempt)) THEN YNoWH NURSE: Enter reason for not getting both measurements. 1 Refused "Both measurements refused" 2 TryNot "Attempted but not obtained" 3 NoTry "Measurement not attempted" IF (RespWH = One OR Refused OR NoTry) OR (YNoWH = Refused) THEN

WHPNABM NURSE: Give reason(s) (for refusal/why unable/for not obtaining measurement/for not attempting/why only one measurement obtained). CODE ALL THAT APPLY. 1 ChairBnd "participant is chairbound" 2 Bed "participant is confined to bed" 3 Stoop "participant is too stooped" 4 NotUnd "participant did not understand the procedure" 5 Other "Other (SPECIFY AT NEXT QUESTION)"

IF (WHPNABM = OthWH) THEN

OthWH NURSE: Give full details of 'other' reason(s) for not getting full waist/hip measurement. : STRING [140]

IF AT LEAST ONE WAIST MEASUREMENT OBTAINED (IF (Waist (1st) \<> 999.9 AND Waist (1st) \<> EMPTY) OR (Waist (2nd) \<> 999.9 AND Waist (2nd) \<> EMPTY)) THEN

WJRel NURSE: Record any problems with waist measurement: 1 NoProb "No problems experienced, reliable waist measurement" 2 ProbRel "Problems experienced - waist measurement likely to be reliable" 3 ProbSlUn "Problems experienced - waist measurement likely to be slightly unreliable" 4 ProbUn "Problems experienced - waist measurement likely to be unreliable"

IF (WJRel = ProbRel OR ProbSlUn OR ProbUn) THEN

ProbWJ NURSE: Record whether problems experienced are likely to increase or decrease the waist measurement. 1 Increase "Increases measurement" 2 Decrease "Decreases measurement"

IF AT LEAST ONE HIP MEASUREMENT OBTAINED IF ((Hip (1st) \<> 999.9 AND Hip (1st) \<> EMPTY) OR (Hip (2nd) \<> 999.9 AND Hip (2nd) \<> EMPTY)) THEN

HJRel NURSE: Record any problems with hip measurement: 1 NoProb "No problems experienced, reliable hip measurement" 2 ProbRel "Problems experienced - hip measurement likely to be reliable" 3 ProbSlUn "Problems experienced - hip measurement likely to be slightly unreliable" 4 ProbUn "Problems experienced - hip measurement likely to be unreliable"

IF (HJRel = ProbRel OR ProbSlUn OR ProbUn) THEN

ProbHJ NURSE: Record whether problems experienced are likely to increase or decrease the hip measurement. 1 Increase "Increases measurement" 2 Decrease "Decreases measurement"

IF (RespWH = Both OR One) THEN

WHRes NURSE: Offer to write results of waist and hip measurements, where applicable, onto respondent's Measurement Record Card. (results displayed) Press \<1> and <Enter> to continue. 1 Continue BMI TO GP CONSENT

IF (GPRegBP \<> Yes) THEN GPRegBM NURSE CHECK: Is participant registered with a GP? 1 Yes "participant registered with GP" 2 No "participant not registered with GP"

IF (GPRegBP = Yes) THEN ConsBMI During the first stage, the interviewer measured your height and weight and from this, your Body Mass Index (BMI) was calculated. BMI is a way of telling if you're a healthy weight for your height. May we send your BMI calculation to your GP? NURSE: Tell them that it was calculated to be (BMI measurement)/ tell them that it is not available from first stage interview. 1 Yes 2 No

IF (ConsBMI = Yes) THEN Code07 NURSE: ASK participant TO INITIAL STATEMENT 4 IN 'BMI (TO GP) CONSENT' SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET. ASK participant TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES (IF NOT ALREADY DONE). CIRCLE CONSENT CODE 07 AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue 1 Continue

IF (ConsBMI = No) OR (PBMI\<>RESPONSE) THEN Code08 NURSE: THE participant DOES NOT WANT THEIR BMI CALCULATION SENT TO THEIR GP/ WE DO NOT HAVE A BMI MEASUREMENT FOR THIS participant SO WE CANNOT SEND IT TO THEIR GP. CIRCLE CONSENT CODE 08 (NO CONSENT FOR FOR BMI TO GP) AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue 1 Continue BLOOD SAMPLE FOR ALL participants WHO ARE NOT PREGNANT

IF (Age >4) AND (Pregnant = No) BLIntro NURSE: NOW FOLLOWS THE BLOOD SAMPLE MODULE. NURSE: EXPLAIN THE PURPOSE AND PROCEDURE OF THE FASTING BLOOD SAMPLE. GIVE PARTICIPANT RELEVANT LEAFLETS. Press \<1> and <Enter> to continue. 1 Continue

IF (age \<16) THEN ClotB ASK PARENT (‘parent name’): May I just check, do/does you/(child’s name) have a clotting or bleeding disorder or are/is you/he/she currently on anti-coagulant drugs such as Warfarin? NURSE: DO NOT TAKE SAMPLE IF PARTICIPANT IS TAKING: Warfarin, Sinthrome (Acenocoumarol), Pehnindione, Pradaxa (Dabigatran Etxililate), Xarelto (Rivaroxaban), Apixaban (Eliquis), Dabigatran etexilate (Pradaxa), Rivatoxaban (Xarelto) TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Aspirin (Caprin; Nu-Seals), Flamasacard, Clopidogrel (Plavix) Dipyridamole (Persantin, Persantin Retard, Asasantin Retard), Prasugrel (Efient), Eptifibate (Inteligrin), Tirofiban (Aggrastat) 1 Yes 2 No

IF (age < 16) AND (ClotB = No) THEN Fit ASK PARENT (‘parent name’): May I just check, have/has you/(child’s name) ever had a fit (including epileptic fit, convulsion, convulsion associated with high fever)? 1 Yes 2 No

IF (age >=16) THEN ClotBA May I just check, do you have a clotting or bleeding disorder or are you currently on anti-coagulant drugs such as Warfarin? NURSE: DO NOT TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Warfarin, Sinthrome (Acenocoumarol), Pehnindione, Pradaxa (Dabigatran Etxililate), Xarelto (Rivaroxaban), Apixaban (Eliquis), Dabigatran etexilate (Pradaxa), Rivatoxaban (Xarelto) TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Aspirin (Caprin; Nu-Seals), Flamasacard, Clopidogrel (Plavix) Dipyridamole (Persantin, Persantin Retard, Asasantin Retard), Prasugrel (Efient), Eptifibate (Inteligrin), Tirofiban (Aggrastat) 1 Yes 2 No

IF (age >= 16) AND (ClotBA=No) THEN FitA May I just check, have you had a fit (including epileptic fit or convulsion,) in the last five years? 1 Yes 2 No IF (age >= 16) AND (ClotBA = No) AND (FitA = No) THEN BSWill Would you be willing to have a fasting blood sample taken? NURSE: THE PARTICIPANT SHOULD FAST FOR 8 HOURS. REMIND HE/SHE THAT THEY CAN AND SHOULD DRINK WATER AS NORMAL. 1 Yes “Yes” 2 No “No” 3 Unable “Participant unable to give a blood sample for reason other than refusal (please specify at next question)”

IF (age>=4 – 16) AND (ClotB = No) AND (Fit = No) THEN CBSConst ASK PARENT (‘parent’): Are you willing for your child to have a blood sample taken? IF (AXMDAge=10) AND (CAgeNow = 11) THEN NURSE: AS PARTICIPANT HAS TURNED 11 YEARS SINCE THE INTERVIEWER STAGE, YOU SHOULD TAKE THE BLOOD SAMPLE NOT A PAEDIATRIC PHLEBOTOMIST OR AN ‘EXTENDED ROLE’ NURSE (I.E. COMPLETED TRAINING TO TAKE BLOOD FROM CHILDREN AGED 6-10INC). N.B. FOR ALL OTHER PARTS OF THE VISIT INTERVIEW AGE IS STILL SET AS 10 YEARS FROM THE INTERVIEWER STAGE. IF (Age \<11) THEN NURSE: AS PARTICIPANT IS 10 YEARS OR UNDER, A PAEDIATRIC PHLEBOTOMIST OR AN “EXTENDED ROLE” NURSE (I.E. COMPLETED TRAINING TO TAKE BLOOD FROM CHILDREN AGED 6-10 INC) MUST TAKE THE BLOOD SAMPLE. IF (Age >=4) THEN CHILDREN AGED 4 AND OVER SHOULD PROVIDE A FASTING SAMPLE. 1 Yes “Yes” 2 No “No” 3 Unable “Participant unable to give blood sample for reason other than refusal (please specify at next question)”

IF (BSWill = Yes) or (CBSConst = Yes) THEN LabChk NURSE: CHECK THE PARTICIPANT’S DATE OF BIRTH AND GENDER AGAINST THE BARCODED LABELS ON THE MONOVETTE TUBES. Date of birth: Gender: IF ANY DETAIL IS INCORRECT CONTACT HNR IMMEDIATELY Press \<1> and <Enter> to continue

IF (BSWill = No) OR (CBSConst = No) THEN RefBSC NURSE: Record why blood sample refused. CODE ALL THAT APPLY. 1 PrevDiff “Previous difficulties with venepuncture” 2 Fear “Dislike/fear of needles” 3 RecTest “Participant recently had blood test/health check” 4 Ill “Refused because of current illness” 5 HIV “Worried about HIV or AIDS” 6 NoPaed “No paediatric phlebotomist or ‘extended role’ nurse available” 7 Parent “Parent doesn’t agree with it/thinks child too young” 8 Busy “Too busy” 9 Time “Time constraints (i.e. appointment timings not convenient)” 97 Other “Other” IF (RefBSC = Other) THEN OthRefBS NURSE: Give full details of other reason(s) for refusing blood sample. : STRING [135]

IF (BSWill = Unable) OR (CBSConst = Unable) THEN UnReas NURSE: Record why participant unable to give a blood sample (i.e. reason other than refusal). : STRING[100]

IF ((age < 16) AND (ClotB = Yes) OR (Fit = Yes)) OR ((age >= 16) AND (ClotBA = Yes) OR (FitA = Yes)) THEN BSStop NURSE: No Blood Samples should be taken from (participant name) Ring consent codes 10, 12, 14 and 16 on the consent booklet To continue with this schedule on the first visit, press \<1> and <Enter> 1 Continue

IF (age >= 4) AND ((BSWill = Yes) OR (CBSConst = Yes)) THEN Diabetes NURSE: HAS THE PARTICIPANT TOLD YOU THAT THEY ARE DIABETIC AND UNWILLING TO FAST? IF PARTICIPANT IS DIABETIC AND CONCERNED ABOUT FASTING, PRESS F9 FOR GUIDANCE ABOUT THE DIFFERENT MEASURES THAT A DIABETIC COULD TAKE AND STILL GIVE A FASTING BLOOD SAMPLE. CODE BELOW WHETHER PARTICIPANT WILLING TO GIVE A FASTING BLOOD SAMPLE. Acceptable procedures according to medication: …participants on oral hypoglycaemic medication should be able to fast without complications. …participants on a combination of nighttime insulin and daytime tablets should also be able to fast unless they are known to have low blood sugar levels first thing in the morning. If they do have low blood sugar in the morning, they could still fast but should reduce their nighttime insulin by a small amount and have breakfast as soon as possible after the blood is taken. …participants on insulin alone can also provide a fasting sample, but should be given special consideration. They should postpone their morning insulin and should be seen as early in the day as possible. In every case, diabetics should have breakfast as soon as possible after blood is taken.

Note that the option of providing a non-fasting sample is only open to diabetics and participants under the age of 4. Blood should not be taken from participants who are willing to provide a sample but are not prepared to fast. 1 NotDiab "Not diabetic/not mentioned" 2 Yes "Diabetic and willing to give fasting blood" 3 No "Diabetic and not willing to give fasting blood sample"

IF (Diabetes = No) THEN DiabNF NURSE: THIS PERSON SHOULD GIVE A NON -FASTING BLOOD SAMPLE. THIS BLOOD SAMPLE SHOULD BE TAKEN AT THE SAME TIME AS A FASTING BLOOD SAMPLE FROM OTHER HOUSEHOLD MEMBERS (IF APPLICABLE). Press \<1> and <Enter> to continue. 1 Continue

IF (Diabetes = NotDiab OR Yes) THEN IsTime NURSE: IS THE TIME CURRENTLY BEFORE 10 AM? (The computer says time is (time on laptop)) IsTimeT Time that IsTime was first asked.

: TIMETYPE

IF (IsTime = Yes) AND (Computer time = before 10am) THEN

Eat Can I check, have you had anything to eat or drink (excluding water) in the last 8 hours? 1 Yes 2 No

IF (Age >=4 -11) AND (BSWill = Yes) OR (CBSConst= Yes) AND (Diabetes = No) THEN

NFastBl NURSE: THIS participant COULD GIVE A NON -FASTING BLOOD SAMPLE NOW. BEFORE DECIDING WHETHER TO TAKE BLOOD, CHECK: IF ((age < 11) AND (Nurse = paediatric phlebotomist)) ARE YOU A TRAINED PAEDIATRIC PHLEBOTOMIST OR A NURSE WHO HAS TAKEN ON THE ‘EXTENDED ROLE’ (I.E. CAN TAKE BLOODS FROM CHILDREN AGED 6-10 YEARS INC)? (IF NO, CODE 2) Are the labs open (i.e. is it Monday - Thursday)/expecting a sample? Is there anyone else in the household who will give blood? If so, could you take blood from both participants at the same time (i.e. a return visit)? CONSIDER THESE QUESTIONS AND CODE: 1 Yes Yes, I will take the blood sample now 2 No No, I will return at a later date to take the blood sample

IF (Age >=11) AND (BSWill = Yes) OR (CBSConst= Yes) AND (Diabetes = No) THEN

NFastBl NURSE: THIS participant COULD GIVE A NON -FASTING BLOOD SAMPLE NOW. BEFORE DECIDING WHETHER TO TAKE BLOOD, CHECK: Are the labs open (i.e. is it Monday - Thursday)/expecting a sample? Is there anyone else in the household who will give blood? If so, could you take blood from both respondents at the same time (i.e. a return visit)? CONSIDER THESE QUESTIONS AND CODE: 1 Yes Yes, I will take the blood sample now 2 No No, I will return at a later date to take the blood sample

IF (NFastBl = No) THEN

NFSAppt NURSE: ARRANGE AN APPOINTMENT WITH (respondent's name) TO TAKE A BLOOD SAMPLE. THIS CAN ONLY BE ON A MONDAY TO THURSDAY MORNING. Press \<1> and<Enter> to continue. 1 Continue

IF (Eat = No) AND (AGE\<11)) THEN

FastBl NURSE: THIS PARTICIPANT COULD GIVE A FASTING BLOOD SAMPLE NOW. BEFORE DECIDING WHETHER TO TAKE BLOOD, CHECK: ARE YOU A TRAINED PAEDIATRIC PHLEBOTOMIST OR A NURSE WHO HAS TAKEN ON THE ‘EXTENDED ROLE’ (I.E. CAN TAKE BLOODS FROM CHILDREN AGED 6-10 YEARS INC)? Are the labs open and expecting a sample? Is there anyone else in the household who will give blood? If so, you should take blood from both participants at the same time. CONSIDER THESE QUESTIONS AND CODE: 1 Yes "Yes, I will take the fasting blood sample now" 2 No "No, I will return at a later date to take the blood sample"

IF (Eat = No) AND ((AGE >11) OR ((CAgeNow =11) AND (PSeqNo\<>1)) THEN FastBl NURSE: THIS PARTICIPANT COULD GIVE A FASTING BLOOD SAMPLE NOW. BEFORE DECIDING WHETHER TO TAKE BLOOD, CHECK: Are the labs open/expecting a sample? Is there anyone else in the household who will give blood? If so, you should take blood from both participants at the same time. CONSIDER THESE QUESTIONS AND CODE: 1 Yes "Yes, I will take the fasting blood sample now" 2 No "No, I will return at a later date to take the blood sample"

IF (FastBl = No) THEN FBApt NURSE: ARRANGE AN APPOINTMENT WITH (participant's name) TO TAKE A BLOOD SAMPLE. THIS SHOULD BE BEFORE 10AM, MONDAY TO THURSDAY ONLY PRESS \<1> AND <ENTER> TO CONTINUE. 1 Continue

IF (age < 6) THEN AmeInt NURSE: Explain that there is the option of using Ametop gel, but that a sample can be given without it. Give parent/participant the Ametop information sheet and allow them time to read it. Ask participant/parent whether they think they will want to use Ametop. If they do, you need to schedule your return appointment before 9.30am. Press \<1> and <Enter> to continue. 1 Continue

IF (age = 6-15) THEN AmeInt NURSE: Explain that there is the option of using Cryogesic spray or Ametop gel, but that a sample can be given without them. Give parent/participant the Cryogesic and Ametop information sheets and allow them time to read them. Ask participant/parent whether they think they will want to use Cryogesic spray or Ametop gel. If they do, you need to schedule your return appointment before 9.30am. Press \<1> and <Enter> to continue. 1 Continue

IF (age >= 16) THEN AmeInt NURSE: Explain that there is the option of using Cryogesic spray, but that a sample can be given without it. Give parent/participant the Cryogesic information sheet and allow them time to read it. Ask participant/parent whether they think they will want to use Cryogesic spray. If they do, you need to schedule your return appointment before 9.30am. Press \<1> and <Enter> to continue. 1 Continue

IF BLOOD SAMPLE NOT TAKEN ON FIRST VISIT THEN IntFBT NURSE: NOW FOLLOWS THE MODULE TO OBTAIN BLOOD SAMPLES. Press \<1> and <Enter> to continue. 1 Continue

DateFBT Date at start of QFBTaken block : DATETYPE

TimeFBT Date at start of QFBTaken block : DATETYPE

IF (PVisit\<>1) AND (age \<16) THEN TClotB ASK PARENT: May I just check again, does (child's name) have a clotting or bleeding disorder or is he/is she currently on anti-coagulant drugs such as Warfarin? NURSE: DO NOT TAKE SAMPLE IF PARTICIPANT IS TAKING: Warfarin, Sinthrome (Acenocoumarol), Pehnindione, Pradaxa (Dabigatran Eteixilate), Xarelto (Rivaroxaban), Apixaban (Eliquis), Dabigatran etexilate (Pradaxa), Rivatoxaban (Xarelto) TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Aspirin (Caprin; Nu-Seals), Flamasacard, Clopidogrel (Plavix) Dipyridamole (Persantin, Persantin Retard, Asasantin Retard), Prasugrel (Efient), Eptifibate (Integrin), Tirofiban (Aggrastat) 1 Yes 2 No

IF (age < 16) AND (TClotB=No) THEN TFit ASK PARENT: May I just check also, has (child's name) ever had a fit (including epileptic fit, convulsion, convulsion associated with high fever)? 1 Yes 2 No

IF (PVisit\<>1) AND (age >= 16) THEN TClotBA May I just check, do you have a clotting or bleeding disorder or are you currently on anti-coagulant drugs such as Warfarin? (NURSE: Aspirin therapy is not a contraindication for blood sample) NURSE: DO NOT TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Warfarin, Sinthrome (Acenocoumarol), Pehnindione, Pradaxa (Dabigatran Eteixilate), Xarelto (Rivaroxaban), Apixaban (Eliquis), Dabigatran etexilate (Pradaxa), Rivatoxaban (Xarelto) TAKE BLOOD SAMPLE IF RESPONDENT IS TAKING: Aspirin (Caprin; Nu-Seals), Flamasacard, Clopidogrel (Plavix) Dipyridamole (Persantin, Persantin Retard, Asasantin Retard), Prasugrel (Efient), Eptifibate (Integrin), Tirofiban (Aggrastat) 1 Yes 2 No

IF (age > 16) AND (TClotBA= No) THEN TFitA May I just check, have you had a fit (including epileptic fit or convulsion,) in the last five years? 1 Yes 2 No

IF (PVisit\<>1) AND (TFitA = No) AND (Age >=4) AND (PDiabetes = 3) AND (TClotB OR TClotBA = No)THEN TEat Can I check, have you had anything to eat or drink (excluding water) in the last 8 hours?

NURSE: Please note this participant is a diabetic and is willing to give a non-fasting blood sample

1 Yes 2 No

IF (PVisit\<>1) AND (TFitA = No) AND (Age >=4) THEN

TEat Can I check, have you had anything to eat or drink (excluding water) in the last 8 hours?

1 Yes 2 No

IF (PVisit = 2 AND TEat =YES) Then

TBSStop NO BLOOD SAMPLES SHOULD BE TAKEN FROM (participant’s name). CIRCLE CONSENT CODES 10, 12, 14 AND 16 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET.

To continue with this schedule on the first visit, press \<1> and <Enter>

1 Continue

IF (Age \<4) THEN

ChEat Can I check, has (participant name) had anything to eat or drink (excluding water) in the last 8 hours?

1 Yes 2 No

IF (PVisit \<> 3) AND (PDiabetes \<> 3) AND (TEat = Yes) OR (ChEat = Yes) THEN

ReArr NURSE: The participant has eaten something and cannot give a fasting blood sample today. Try to rearrange the appointment for another day.

1 Appt "Appointment rearranged to take blood" 2 NoAppt "Not able to make another appointment"

IF (2nd visit AND ReArr = NoAppt) OR (3rd visit) THEN

TBSStop NO BLOOD SAMPLES SHOULD BE TAKEN FROM (participant name). CIRCLE CONSENT CODES 10, 12, 14 and 16 AT QUESTION 8 ON THE FRONT OF THE OFFICE CONSENT BOOKLET.

To continue with this schedule on the first visit, press \<1> and <Enter>.

1 Continue

IF (2nd visit AND ReArr = Appt) THEN

TBSNoV2 NO BLOOD SAMPLES SHOULD BE TAKEN FROM (participant’s name) NOW. YOU WILL NEED TO MAKE ANOTHER VISIT TO TAKE BLOOD.

To continue with this schedule on the first visit, press \<1> and <Enter>.

1 Continue

IF (age >= 16) THEN

TBSWill Would you be willing to have a fasting/(non-fasting) blood sample taken?

1 Yes 2 No 3 Unable “participant unable to give blood for reason other than refusal (please specify at next question)” IF (age < 16) THEN TCBSConst ASK PARENT Are you willing for your child to have a fasting/(non-fasting) blood sample taken? NURSE: CHECK THAT CHILD IS WILLING ALSO, EXPLAIN PROCESS AND REASSURE THEM. IF (age < 11) THEN EXTENDED ROLE NURSES CANNOT TAKE CHILD BLOODS AFTER 20 SEPT 2013 UNLESS THEY HAVE BEEN ON THE PAEDIATRIC VENEPUNCTURE PROGRAMME. ELSEIF (CAgeNow\<11) THEN ONLY TRAINED PAEDIATRIC PHLEBOTOMISTS OR "EXTENDED ROLE" NURSES (I.E. COMPLETED TRAINING TO TAKE BLOOD FROM CHILDREN AGED 6-10 INC) SHOULD TAKE BLOOD FROM CHILDREN UNDER 11.

Remember up to 2 attempts at blood are now allowed for under 16's. The 2nd attempt must be from the other arm to the 1st.

1 Yes 2 No 3 Unable “participants unable to give blood for reason other than refusal (please specify at next question)”

IF (age>=6) THEN CryUse (ASK PARENT) Do you want Cryogesic spray to be used? 1 Yes 2 No

IF (CryUse= Yes) THEN CryAll (ASK PARENT) Has (child name)/ have you ever had a bad reaction to ethyl chloride? NURSE: If participant doesn't know enter Ctrl+k. The participant can still use cryogesic spray. 1 Yes 2 No

IF (CryAll=Yes) AND (Age = 6-15) THEN NoCry1 NURSE: Cryogesic spray cannot be used. Is participant willing to give a blood sample with the use of Ametop gel? Code 1 if 'Yes, willing to give blood sample with Ametop gel' Code 2 if 'Not with Ametop but will give a blood sample' Code 3 if 'Not willing to give blood sample without Cryogesic'.

1 Yes "Willing to sample with Ametop" 2 NoAm "Not with Ametop but will give sample" 3 None "No blood sample"

IF (CryAll=Yes) AND (age>=16) THEN NoCry2 NURSE: Cryogesic spray cannot be used. Is respondent willing to give a blood sample without Cryogesic spray? Code 1 if 'Yes, willing to give blood sample without Cryogesic spray' Code 2 if 'Not willing to give blood sample without Cryogesic'.

1 Yes "Willing to sample without Cryogesic" 2 None "No blood sample"

IF (CryAll=No) OR (CryAll= Don’t know) THEN DoCry NURSE: Blood sample with Cryogesic spray.

- Apply Cryogesic spray following instructions. Press \<1> and <Enter> to continue. 1 Continue

IF (Age \<6 OR Age = 6 -16) AND (CryUse= No OR NOCry1 = Yes) THEN AmetopUse ASK PARENT Do you want Ametop gel to be used? 1 Yes 2 No

IF (AmetopUse = Yes) THEN Allergy ASK PARENT Have/(Has) you/(he/she) ever had a bad reaction to a local or general anaesthetic bought over the counter at a chemist, or given at the doctor, the dentist or in hospital? $ Yes 2 No

IF (Allergy = Yes) THEN NoAmetop NURSE: Ametop gel cannot be used. Is participant willing to give blood sample without Ametop gel? Code 1 if Yes, willing to give blood sample without Ametop gel Code 2 if No, not willing to give blood sample without Ametop. 1 Yes "Yes, willing" 2 No "No, no blood sample"

IF (Allergy = No) THEN DoAmetop NURSE: Blood sample with Ametop gel.

- Apply Ametop gel following instructions.
- Wait at least half an hour before attempting blood sample.

Press \<1> and <Enter> to continue. 1 Continue

Derived: CryOrAm Whether used Cryogesic or Ametop (DV) 1 Cryogesic 2 Ametop 3 Neither 4 NoBlood

If (CryOrAm = NoBlood) THEN CryAmNo NURSE: participant cannot give blood. Press \<1> and <Enter> to continue. 1 Continue

IF (TBSWill = No) OR (TCBSConst = No) OR (TBSWill = Yes) OR (TCBSConst=Yes) AND (CryOrAm=NoBlood) THEN TRefBSC NURSE: Record why blood sample refused. CODE ALL THAT APPLY. 1 PrevDiff "Previous difficulties with venepuncture", 2 Fear "Dislike/fear of needles", 3 RecTest "participant recently had blood test/health check" 4 Ill "Refused because of current illness", 5 HIV "Worried about HIV or AIDS", 6 NoPaed "No paediatric phlebotomist or 'extended role nurse available", 7 Parent "Parent doesn't agree with it/thinks child too young", 8 Busy "Too busy", 9 Time "Time constraints (i.e. appointment timings not convenient)", 10 Other "Other"

IF (TRefBSC = Other) THEN T0thRef NURSE: Give full details of other reason(s) for refusing blood sample. : STRING [135]

IF (TBSWill = Unable) OR (TCBSConst= Unable) THEN TUnReas NURSE: Record why participant unable to give a blood sample (i.e. reason other than refusal). : STRING [100]

IF (TBSWill = Yes) OR (TCBSConst = Yes) AND (CryOrAm \<> NoBlood) BSConsC NURSE: EXPLAIN NEED FOR WRITTEN CONSENT (from parent): Before I can take any blood, I have to obtain written consent from you/ (the written consent from both parent and child).

IF (Age 5-16) THEN NURSE: IF THE CHILD IS ABLE PLEASE SEEK CHILD ASSENT. Press \<1> and <Enter> to continue. 1 Continue

IF (Age = 18 months - 15 years) THEN GuardCon NURSE CHECK: Is a parent or person with legal responsibility willing to give consent? 1 Yes 2 No

IF (GuardCon = No) THEN Ignore NURSE: Record details of why consent refused. : STRING [140]

IF (GuardCon = Yes) THEN Code 09C NURSE:

- ASK PARENT/LEGAL GUARDIAN TO INITIAL STATEMENT 4 FOR CHILDREN AGED 4-15 OR STATEMENT 3 FOR CHILDREN AGED 1.5-3 IN 'BLOOD SAMPLING CONSENTS' SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET.
- MAKE SURE CHILD’S NAME IS FILLED IN IN BOTH COPIES
- ASK PARENT/LEGAL GUARDIAN TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES (IF NOT ALREADY DONE SO).
- CIRCLE CONSENT CODE 09 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET.
- IF THE CHILD IS AGED 5-15 YEARS ASK THEM TO FILL IN THE CHILD ASSENT FORM WHERE POSSIBLE. Press \<1> and <Enter> to continue. 1 Continue IF(Age > 15) THEN Code09A NURSE:
- ASK PARTICIPANT TO INITIAL STATEMENT 5 IN ‘BLOOD SAMPLING CONSENTS’ SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET.
- MAKE SURE YOU USE THE CORRECT AGE CONSENT FORM
- MAKE SURE PARTICIPANT’S NAME IS FILLED IN IN BOTH COPIES
- ASK PARTICIPANT TO SIGN AND DATE AT THE BOTTOM OF THE PAGE IN BOTH COPIES (IF NOT ALREADY DONE SO).
- CIRCLE CONSENT CODE 09 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (TBSStop was triggered) THEN Code10 NURSE: CIRCLE CONSENT CODE 10 (NO CONSENT FOR BLOOD SAMPLING) AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF ((TBSWill = Yes) OR (TCBSConst=Yes)) AND (CryOrAm \<>NoBlood) AND ((Code09A=RESPONSE) OR (Code09C = RESPONSE)) THEN ConStorB NURSE: ASK PARENT/LEGAL GUARDIAN / ASK PARTICIPANT May we have your consent to store any remaining blood for future analysis?

NURSE: IF ASKED, ‘THE BLOOD WOULD BE USED FOR TESTS RELATING TO NUTRITION AND HEALTH. THE SAMPLE WOULD BE ANONYMISED. THIS MEANS FUTURE RESEARCHERS WOULD NOT KNOW WHO YOU ARE. THE TESTS WOULD BE APPROVED BY AN ETHICS COMMITTEE’.

NURSE: IF ASKED, EXPLAIN THE PARTICIPANT CAN WITHDRAW THEIR CONSENT AT ANY TIME, WITHOUT GIVING ANY REASON, BY ASKING THE INVESTIGATORS IN WRITING FOR BLOOD TO BE REMOVED FROM STORAGE AND DESTROYED.

1 Yes “Storage consent given” 2 No “Consent refused”

IF (ConStorB=Yes) THEN Code11 NURSE: ASK PARENT/LEGAL GUARDIAN / ASK PARTICIPANT TO INITIAL STATEMENT 6 FOR ADULTS, STATEMENT 5 FOR CHILDREN AGED 4-15 OR STATEMENT 4 FOR CHILDREN AGED 1.5-3 BOX IN ‘BLOOD SAMPLING CONSENTS’ SECTION IN THE OFFICE CONSENT BOOKLET.

- CIRCLE CONSENT CODE 11 AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue IF (ConStorB=No) THEN Code12 CIRCLE CONSENT CODE 12 (NO CONSENT FOR BLOOD STORAGE) AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF ((TBSWill = Yes) OR (TCBSConst=Yes)) AND (CryOrAm \<> NoBlood) AND ((Code09A=RESPONSE) OR (Code09C = RESPONSE)) THEN SnDrSam (ASK PARENT) Would you like to be sent the results of your / child’s name blood sample analysis? 1 Yes 2 No

IF (SnDrSam = Yes) THEN Code 13 NURSE:

- ASK PARENT/LEGAL GUARDIAN / ASK PARTICIPANT TO INITIAL STATEMENT 7 FOR ADULTS, STATEMENT 6 FOR CHILDREN AGED 4-15 OR STATEMENT 5 FOR CHILDREN AGE 1.5-3 IN ‘BLOOD SAMPLING CONSENTS’ SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET.
- CIRCLE CONSENT CODE 13 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (SnDrSam = No) THEN Code 14 NURSE: CIRCLE CONSENT CODE 14 AT QUESTION 8 ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF ((PGPRegBP \<>1) AND (PGPRegBM \<>1)) OR (Age = 18 months – 3 years) THEN GPRegFB NURSE CHECK: Is participant registered with a GP? 1 participant registered with GP 2 participant not registered with GP

IF (GPRegFB = Yes) THEN SendSam ASK PARENT/LEGAL GUARDIAN / ASK PARTICIPANT May we send the results of your child’s/your blood sample analysis to his/her/your GP? 1 Yes 2 No

IF (SendSam= No) THEN SenSaC ASK PARENT/LEGAL GUARDIAN / ASK PARTICIPANT Why do you not want your child’s/your blood sample results sent to his/her/your GP? 1 NeverSee “Hardly/never sees GP” 2 RecSamp “GP recently took blood sample” 3 Bother “Does not want to bother GP” 4 Other “Other”

IF (SenSac=Other) THEN OthSam NURSE: Give full details of reasons(s) for not wanting results sent to GP. : STRING [140]

IF (SendSam=Yes) THEN Code15 NURSE:

- ASK PARENT/LEGAL GUARDIAN / PARTICIPANT TO INITIAL STATEMENT 8 FOR ADULTS, STATEMENT 7 FOR CHILDREN AGED 4-15 OR STATEMENT 6 FOR CHILDREN AGED 1.5-3 IN ‘BLOOD SAMPLING CONSENTS’ SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET.
- CHECK THAT GP NAME, ADDRESS AND PHONE NUMBER ARE RECORDED ON FRONT OF OFFICE CONSENT BOOKLET (IF NOT ALREADY DONE).
- CHECK NAME BY WHICH GP KNOWS PARTICIPANTS, AND ENTER ON FRONT OF OFFICE CONSENT BOOKLET (IF NOT ALREADY DONE).
- CIRCLE CONSENT CODE 15 AT QUESTION 8 ON FRONT OF OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (GPRegFB=No) OR (SendSam = No) THEN Code16 NURSE:

- CIRCLE CONSENT CODE 16 AT QUESTION 8 (NO CONSENT FOR BLOOD SAMPLE RESULTS TO GP) ON FRONT OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (Code14 = RESPONSE) AND (Code16 = RESPONSE) THEN NoRes You have indicated that you do not wish to receive your child’s/your blood sample results or have them sent to your GP. NURSE: CHECK THAT THIS IS THE CASE WITH THE PARTICIPANT. IF NECESSARY GO BACK AND AMEND. IF SPEAKING TO THE PARENT/GAURDIAN OF A CHLD AGED 15 OR UNDER EXPLAIN TO THE PARTICIPANT THAT IN THIS CASE THEY WILL NEED TO AGREE FOR THE SURVEY DOCTOR TO CONTACT THEM IF NEEDED (E.G. RESULT IS OUT OF RANGE). IF THEY DON’T AGREE TO THIS A BLOOD SAMPLE CAN NOT BE TAKEN FOR CHILDREN. Press \<1> and <Enter> to continue. 1 Continue

IF (Code14 = RESPONSE) AND (Code16 = RESPONSE) THEN Code17 NURSE:

- THIS PARTICIPANT DOES NOT WANT THEIR RESULTS SENT TO THEM OR THEIR GP. PLEASE ASK THEM TO READ AND INITIAL THE STATEMENT IN THE GREY BOX ON THE RELEVANT CONSENT FORM IN THE OFFICE AND PARTICIPANT CONSENT BOOKLETS:
- STATEMENT 9 FOR 16+ YEARS
- STATEMENT 8i FOR 4-15 YEARS
- STATEMENT 7i FOR 1.5-3 YEARS
- CIRCLE CONSENT CODE 17 ON THE FRONT PAGE OF THE OFFICE CONSENT BOOKLET.

Press \<1> and <Enter> to continue.

IF (Code13 = RESPONSE) OR (Code15 = RESPONSE) THEN Code18 NURSE: THE PARTICIPANT HAS AGREED TO FEEDBACK FROM BLOOD SAMPLE RESULTS (TO GP AND/OR TO THEMSELVES). CIRCLE CONSENT CODES 18 AND 20 ON THE FRONT OF PAGE OF THE OFFICE CONSENT BOOKLET Press \<1> and <Enter> to continue. 1 Continue

IF (Code14 = RESPONSE) AND (Code16 = RESPONSE) AND (age \<16) THEN SurDoc NURSE: TO TAKE A BLOOD SAMPLE FROM THE CHILD THE PARENT/LEGAL GUARDIAN MUST INITIAL OR TICK STATEMENT 8ii ON THE 4-15 CONSENT FORM OR STATEMENT 7ii ON THE 1.5-3 CONSENT FORM. IF THEY DO NOT CONSENT TO THE SURVEY DOCTOR CONTACTING THEM IF NEEDED (E.G. WITH AN OUT OF NORMAL RANGE BLOOD ANALYTE RESULT) YOU MUST NOT TAKE A BLOOD SAMPLE.

Do you agree to the survey doctor contacting you to discuss, if necessary, any results that are directly relevant to your child’s health? 1 Yes 2 No

IF (SurDoc=Yes) THEN Code19 NURSE: ASK PARENT/LEGAL GUARDIAN TO INITIAL STATEMENT 8ii FOR CHILDREN AGED 4-15 OR STATEMENT 7ii FOR CHILDREN AGED 1.5-3 IN ‘BLOOD SAMPLING CONSENTS’ SECTION IN THE OFFICE CONSENT BOOKLET AND THE PERSONAL CONSENT BOOKLET. CIRCLE CONSENT CODE 19 ON THE FRONT OF PAGE OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (SurDoc=No) Code20 NURSE: A BLOOD SAMPLE CAN NOT BE TAKEN FROM THE CHILD.

- CIRCLE CONSENT CODE 20 ON THE FRONT OF PAGE OF THE OFFICE CONSENT BOOKLET. Press \<1> and <Enter> to continue. 1 Continue

IF (CryOrAm = Cryogesic) THEN DoCry NURSE: Blood sample with Cryogesic spray.

- Apply Cryogesic spray following instructions. Press \<1> and <Enter> to continue. 1 Continue IF (Age >=16) THEN TakSAd1 NURSE: First check you have all applicable signatures and the relevant boxes have been initialled or ticked on the consent form. Secondly, check the Date of Birth and Gender on the labels to make sure they are correct. If they aren’t contact HNR before a blood sample is taken. Then … A) Taken blood samples in the following order:
  1. EDTA (2.6ml) tube red cap, label EN1 (3)
  2. Serum (9.0ml) tube white cap, label SEN1 (4)
  3. Lithium heparin (7.5ml) tube orange cap, label LHN1 (5)
  4. Lithium heparin (7.5ml) tube orange cap, label LHN2 (6)
  5. Fluoride (1.2ml) tube yellow cap, label FN1 (7)
  6. Lithium heparin (4.5ml) tube orange cap, label LHN3 (8)
  7. EDTA (2.6ml) tube red cap, label EN2 (9) B) Check the date of birth and gender again with the participant to ensure you have the right labels for the right participant. Contact HNR immediately if they don’t match. C) Stick the barcoded label HORIZONTALLY on the tube. Line the top of the barcoded label with the top of the label already on the tube. This will give a clear area along the length of the tube. D) Stick appropriate barcoded label on the field lab (FL1 (13) and FL2 (14)) and Addenbrookes despatch notes (Adx1, Adx2 and Adx3 (10-12)). E) Remember to attach labels FOL 1 (23) and FOL 2 (24) to the 3 carbonised copies of the completed Addenbrookes research analysis request form using a paperclip. Press \<1> and <Enter> to continue. 1 Continue

IF (Age >=16) THEN TakSAd2 NURSE: All 3 copies of the Addenbrookes research Analysis request form, the FOL1 FOL2 labels and EDTA tube should be posted in the white jiffy envelope to the Addenbrookes hospital. Please take careful note of the order (and therefore numbering) of the Addenbrookes and Monovette labels.

- Check to ensure you have used the correct barcoded labels for THIS participant…… Serial number: PLEASE REMEMBER TO DELIVER A PACK OF MICROTUBES (PARTICIPANT AGED 16 + - PINK LABELLED MICROTUBES PACK), FIELD LAB LABELS 15-22 AND FIELD LAB DESPATCH NOTE TO YOUR LOCAL LAB WHEN YOU DELIVER THESE SAMPLES! Press \<1> and <Enter> to continue. 1 Continue

IF (Age = 7-15) THEN TakSCO1 NURSE: First check you have all applicable signatures and the relevant boxes have been initialled OR ticked on the consent form. Secondly, check the Date of Birth and Gender on the labels to make sure they are correct. If they aren’t contact HNR before a blood sample is taken. Then… A) Take blood samples in the following order (Child 7-15 years - GREEN labelled monovette pack):

1. EDTA (2.6ml) tube red cap, label EN1 (3)
2. Serum (7.5ml) tube white cap, label SEN1 (4)
3. Lithium heparin (7.5ml) tube orange cap, label LHN1 (5)
4. Lithium heparin (7.5ml) tube orange cap, label LHN2 (6)
5. Fluoride (1.2ml) tube yellow cap, label FN1 (7) B) Check the date of birth and gender again with the participant to ensure you have the right labels for the right participant. Contact HNR immediately if they don’t match. C) Stick the barcoded label HORIZONTALLY on the tube. Line the top of the barcoded label with the top of the label already on the tube. This will give a clear area along the length of the tube.

D) Stick appropriate barcoded label on the field lab (FL1 (13) and FL2 (14)) and Addenbrookes despatch notes (Adx1, Adx2 and Adx3 (10-12)).

E) Remember to attach labels FOL 1 (23) and FOL 2 (24) to the 3 carbonised copies of the completed Addenbrookes research analysis request form using a paperclip.

Press \<1> and <Enter> to continue.

IF (Age = 7-15) THEN

TakSCO2

NURSE:

All 3 copies of the Addenbrookes research Analysis request form, the FOL1 FOL2 labels and EDTA tube should be posted in the white jiffy envelope to the Addenbrookes hospital.

Please take careful note of the order (and therefore numbering) of the Addenbrookes and Monovette labels.

- Check to ensure you have used the correct barcoded labels for this participant……. Serial number:

PLEASE REMEMBER TO DELIVER A PACK OF MICROTUBES (PARTICIPANT AGED 7-15 – GREEN LABELLED MICROTUBE PACK), FIELD LAB LABELS 15-22 AND FIELD LAB DESPATCH NOTE TO YOUR LOCAL LAB WHEN YOU DELIVER THESE SAMPLES!

Press \<1> and <Enter> to continue

IF (Age= 18 months – 6 years)

TakSCY

NURSE: First check you have all applicable signatures and the relevant boxes have been initialled OR ticked on the consent form. Secondly, check the Date of Birth and Gender on the labels to make sure they are correct. If they aren’t contact HNR before a blood sample is taken. Then…

A) Take blood samples in the following order (Child 1.5-6 years – BLUE labelled monovette pack):

1. EDTA (2.6ml) tube red cap, label EN1 (3)
2. Serum (4.5ml) tube white cap, label SEN1 (4)
3. Lithium heparin (4.5ml) tube orange cap, label LHN1 (5)

B) Check the date of birth and gender again with the participant to ensure you have the right labels for the right participant. Contact HNR immediately if they don’t match.

C) Stick the barcoded label HORIZONTALLY on the tube. Line the top of the barcoded label with the top of the label already on the tube. This will give a clear area along the length of the tube.

D) Stick appropriate barcoded label on the field lab (FL1 (13) and FL2 (14)) and Addenbrookes despatch notes (Adx1, Adx2 and Adx3 (10-12)).

- Check to ensure you have used the correct barcoded labels for this participant……. Serial number:

PLEASE REMEMBER TO DELIVER A PACK OF MICROTUBES (PARTICIPANT AGED 18mths-6yrs – BLUE LABELLED MICROTUBES PACK), FIELD LAB LABELS 15-22 AND FIELD LAB DESPATCH NOTE TO YOUR LOCAL LAB WHEN YOU DELIVER THESE SAMPLES!

Press \<1> and <Enter> to continue

IF (Age >=16) THEN

SampF1A

NURSE: Code if the 1st EDTA (red, 2.6ml) tube filled (label EN1 (3)).

1 YesF “Yes, FULLY filled”, 2 YesP “Yes, PARTIALLY filled”, 3 No “No, not filled”

IF (Age >=16) THEN SampF2A NURSE: Code if the serum (white, 9.0ml) tube filled (label SEN1 (4)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF AND (Age >=16) THEN SampF3A NURSE: Code if the 1st Lithium heparin (orange, 7.5ml) tube filled (label LHN1 (5)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age >=16) THEN SampF4A NURSE: Code if the 2nd Lithium heparin (orange, 7.5ml) tube filled (label LHN2 (6)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age >=16) THEN SampF5A NURSE: Code if the fluoride (yellow, 1.2ml) tube filled (label FN1 (7)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age >=16) THEN SampF6A NURSE: Code if the 3rd Lithium heparin (orange, 4.5ml) tube filled (label LHN3 (8)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age >=16) THEN SampF7A NURSE: Code if the 2nd EDTA (red, 2.6ml) tube filled (label EN2 (9)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age = 7-15) THEN SampF1CO NURSE: Code if the EDTA (red, 2.6ml) tube filled (label EN1 (3)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age = 7-15) THEN SampF2CO NURSE: Code if the serum (white, 7.5ml) tube filled (label SEN1 (4)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age = 7-15) THEN SampF3CO NURSE: Code if the 1st Lithium heparin (orange, 7.5ml) tube filled (label LHN1 (5)). IF (Age = 7-15) THEN SampF4CO NURSE: Code if the 2nd Lithium heparin (orange, 7.5ml) tube filled (label LHN2 (6)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age = 7-15) THEN SampF5CO NURSE: Code if the fluoride (yellow, 1.2ml) tube filled (label FN1 (7)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age= 18 months – 6 years) SampF1CY NURSE: Code if the EDTA (red, 2.6ml) tube filled (label EN1 (3)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age= 18 months – 6 years) SampF2CY NURSE: Code if the Serum (white, 4.0ml) tube filled (label SEN1 (4)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

IF (Age= 18 months – 6 years) SampF3CY NURSE: Code if the Lithium heparin (orange, 1.1ml) tube filled (label LHN1 (5)). 1 YesF "Yes, FULLY filled", 2 YesP "Yes, PARTIALLY filled", 3 No "No, not filled"

SampTak (Derived from SampF1A – SampF3CY) Blood sample outcome: 1 YesF "Blood sample obtained - all full" 2 YesP "Blood sample obtained - not all full" 3 No "No blood sample obtained"

IF (SampTak = YesF) OR IF (SampTak = YesP) SamDifC NURSE: Record any problems in taking blood sample. CODE ALL THAT APPLY. 1 NoProb "No problem", 2 Small "Incomplete sample", 3 BadVein "Collapsing/poor veins", 4 TakeTwo "Second attempt necessary", 5 Faint "Some blood obtained, but participant felt faint/fainted", 6 NoTour "Unable to use tourniquet", 7 Other "Other (SPECIFY AT NEXT QUESTION)" IF (SamDifC = Other) THEN OthBDif NURSE: Given full details of other problem(s) in taking blood sample. : STRING [140]

IF (SampTak = No) THEN NoBSC NURSE: Code reason(s) why no blood obtained. CODE ALL THAT APPLY. NoVein "No suitable or no palpable vein/collapsed veins", Anxious "participant was too anxious/nervous", Faint "participant felt faint/fainted", Other "Other"

IF (NoBSC = Other) THEN OthNoBSM NURSE: Give full details of reason(s) no blood obtained. : STRING [140]

ThanksB NURSE: THANK THE PARTICIPANT FOR THEIR COOPERATION AND GIVE THEM THEIR £20 GIFT CARD. Press \<1> and <Enter> to continue. 1 Continue

GCard Gift card number for participant : STRING [30]

VpSTime Time of answering VpProb TIMETYPE

VpSDate Date of answering VpProb DATETYPE

IF (PVPerNo = 2) AND (age \<11) THEN PhlebID Enter the paediatric phlebotomist’s or ‘extended role’ nurse’s ID number who took the blood sample. Or, if you as an ‘extended role’ nurse took the blood sample enter your ID number. Just enter the 4 digit number. : 0001…9997

IF (PVPerNo = 2) AND (age \<11) THEN VPForm Please remind the paediatric phlebotomist or ‘extended role’ nurse to complete the paper copy of the venepuncture checklist. If you as an ‘extended role’ nurse took the blood sample then please complete the checklist yourself. Press \<1> and <Enter> to continue. 1 Continue

VpHand Was the participant left handed or right handed? 1 Left "Left handed" 2 Right "Right handed" VpArm Which arm did you use to take blood? 1 Left “Left arm” 2 Right “Right arm”

VpSkin Code the skin condition of the arm used. 1 Intact “Skin intact” 2 NotIntac “Skin not intact”

VpAlco Did you use an alcohol wipe? 1 Yes 2 No

IF (PDoCryAme = 1) THEN CryTimH You used cryogesic spray on this participant. What time did you apply the Cryogesic spray? Record the time using a 24 hour clock. Enter the hour here. 0..23

IF (PDoCryAme = 1) THEN CryTimM NURSE: Enter the minutes here. 0..59

IF (PDoCryAme = 1) THEN CryTime What time did you apply the Cryogesic spray? (DV) : TIMETYPE

IF (PDoCryAme = 1) THEN CrySens Was the participant sensitive to Cryogesic spray? IF THERE WAS A SEVERE LOCAL REACTION, participant IS LIGHTHEADED OR SEDATED, CONTACT SURVEY DOCTOR 1 Yes 2 No

IF (PDoCryAme = 1) THEN CryExpD Record the expiry date of the Cryogesic spray used. Enter the day here. 1..31

IF (PDoCryAme = 1) THEN CryExpM NURSE: Enter the code for the month here. 1 January, 2 February, 3 March, 4 April, 5 May, 6 June, 7 July, NDNS YEAR 9 CAPI_NURSE

8 August, 9 September, 10 October, 11 November, 12 December

IF (PDoCryAme = 1) THEN CryExpY NURSE: Enter the year here. 2016-2021

IF (PDoCryAme = 1) THEN CryExp Expiry date of the Cryogesic spray used (Derived) : DATETYPE

IF (PDoCryAme = 1) THEN CryBat Record the batch number of the Cryogesic : STRING [20]

IF (PDoCryAme = 2) THEN AmeTimH You used AMETOP gel on this participant. What time did you apply the AMETOP gel? Record the time using a 24 hour clock. Enter the hour here. 0..23

IF (PDoCryAme = 2) THEN AmeTimM NURSE: Enter the minutes here. : 0..59

IF (PDoCryAme = 2) THEN AmeTime What time did you apply the Ametop gel? (Derived) : TIMETYPE

IF (PDoCryAme = 2) THEN AmeSens Was the participant sensitive to AMETOP Gel? IF THERE WAS A SEVERE LOCAL REACTION, PARTICIPANT IS LIGHTHEADED OR SEDATED, CONTACT SURVEY DOCTOR

IF (PDoCryAme = 2) THEN AmeExpM NURSE: Enter the code for the month here. 1 January, 2 February, 3 March, 4 April, 5 May, 6 June, 7 July, 8 August, 9 September, 10 October, 11 November, 12 December

IF (PDoCryAme = 2) THEN AmeExpY NURSE: Enter the year here. 2016..2050

IF (PDoCryAme = 2) THEN AMEeXP Expiry date of the Ametop used (Derived) DATETYPE

IF (PDoCryAme = 2) THEN AmeBatch Record the batch number of the Ametop : STRING [20]

VpSam Code the number of attempts made to take blood. REMEMBER UP TO 2 ATTEMPTS AT TAKING BLOODS CAN NOW BE MADE FOR BOTH ADULTS AND CHILDREN. 1 First “Sample taken on first attempt” 2 Second “Sample taken on second attempt” 3 Failed “Both attempts failed”

VpPress Code who applied pressure to the puncture site. 1 Nurse 2 Phleb “Phlebotomist or ‘extended role’ nurse” 3 Respondent 4 Parent 5 Partner “Partner or spouse”

VpSens Was the participant sensitive to the tape or plaster? 1 Sense “Sensitive to tape/plaster” 2 Notsense “Not sensitive to tape/plaster” 3 NotChec “(Did not check)”

VpProb Was there any abnormality noted after 5 minutes? (Please remember to recheck the site after completion of the blood sample module.) 1 Sense “Sensory deficit” 2 Haematoma 3 Swelling 4 Other “Other (describe at next question)” 5 None

IF (VpProb= Other) THEN VpOther Record the details of the other abnormality fully. : STRING [135]

IF (VpProb\<>None) THEN VpDetail You have coded that an abnormality was noted after 5 minutes. Please record the action you took when you noticed this abnormality in the Office Consent Booklet. There is space at the back of the Office Consent Booklet for you to write up these details fully. Press \<1> and <Enter> to continue 1 Continue

VpCheck Did you re-check the puncture site after completion of the blood sample module? 1 Yes "Yes, site was re-checked" 2 No "No, site was not re-checked"

IF (PVPerNo = 2) AND (Age < 11) THEN PhlebVP NURSE: PLEASE REMEMBER TO COLLECT THE COMPLETED VENEPUNCTURE CHECKLIST FROM THE PAEDIATRIC PHLEBOTOMIST OR 'EXTENDED ROLE' NURSE AND RETURN IT TO THE OFFICE. EXTENDED ROLE NURSE: PLEASE COMPLETE THE VENEPUNCTURE CHECKLIST AND RETURN TO THE OFFICE Press \<1> and <Enter> to continue. 1 Continue

DRUGS

DrC1 NURSE : Enter code for (Drug name). Enter 999996 if unable to code/ Enter 999999 if unable to code : STRING [6]

IF (SUBSTRING (DrC1, 1,2) = '02') and (DrC1 \<> '021200') AND (Age >15) THEN YTake1 Do you take (Drug name) because of a heart problem, high blood pressure or for some other reason?

1. Heart "Heart problem"
2. HBP "High blood pressure"
3. Other "Other reason"

IF (YTake1 = Other THEN TakeOth1 NURSE : Give full details of reason(s) for taking (Drug name). Press <Esc> when finished.